Development of a self-report measure of drug craving

Abstract

The construct of craving is frequently invoked as a causal factor in on going substance use or in relapse after a period of abstinence. The aim of the present study is to develop a general self-report questionnaire of craving that can be used to assess craving at any point in addiction and recovery. The study was conducted in two phases. In the first phase of the study a sample of 23 addicts were interviewed about their subjective experience of craving. The purpose of this phase of the study was to develop a theory of the subjective experience of craving that could be used to guide the development of the self-report questionnaire. Analysis of the text of these interviews revealed nine dimensions of the subjective experience of craving: specificity, strength, positive outcomes, behavioral intention, physical symptoms, affect, internal cues, situations, and drug availability. The first six dimensions were hypothesized to load on a general craving factor, and the last three dimensions were hypothesized to load on a cue reactivity factor. Questionnaire items were generated to broadly sample each of these dimensions. In the second phase the questionnaire was administered to a heterogenous sample of 205 addicts. Confirmatory factor analytic procedures were used to assess the present theory of craving and the psychometric properties of the instrument. The two factor model of craving fit the data well based on practical fit indices (Robust CFI =.95) and the discriminant validity of the two factors was supported. These analyses supported the theory of craving underlying the development of the questionnaire and indicated that the questionnaire has acceptable psychometric properties. The theoretical, psychometric, and clinical implications of the results are discussed.